Provider Demographics
NPI:1679860332
Name:MCCAULEY, MATHEW PATRICK (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MATHEW
Middle Name:PATRICK
Last Name:MCCAULEY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 41
Mailing Address - Street 2:BOX 2971
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09464-0345
Mailing Address - Country:US
Mailing Address - Phone:44163-852-8603
Mailing Address - Fax:
Practice Address - Street 1:PSC 41
Practice Address - Street 2:BOX 2971
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09464
Practice Address - Country:US
Practice Address - Phone:44163-852-8603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZPYL18880103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist